SED Participant Consent Form

Attachment 6: Participant Consent Form

42

Participant Consent Form
The National Science Foundation designs, conducts, and sponsors surveys on science,
engineering, and technology. In order to produce the best information possible, the National
Science Foundation routinely evaluates its surveys.
You have volunteered to take part in a study to improve one of the National Science
Foundation’s surveys. In order to have a complete record of your comments, your interview
session will be audio taped (and/or videotaped). We plan to use the tapes to improve the survey.
Staff directly involved in this research project will have access to the tapes. In addition, a
transcription service may have access to the audiotapes, to provide us with a written version of
your comments. The tapes may also be used for training others to conduct this type of research,
and in presentations to professional audiences.
This study is authorized by law (42 U.S.C. 1862 Section 3.a.6.). The OMB control number for
this study is 3145-0174.
I have volunteered to participate in this study, and I give permission for my tapes to be used for
the purposes stated above.

_________________________
Researcher’s Signature

____________________________
Participant’s Signature

_________________________
Printed Name

____________________________
Printed Name

_________________________
Date

____________________________
Date

43